Dental periodontitis is an inflammation of an infectious nature that occurs at the membrane of the tooth root and affects the tissues of the oral cavity located next to it. Periodontitis is difficult to confuse with other dental diseases, because it has a clear symptom – severe and constantly increasing pain, which cannot be relieved by taking tablets from the pharmacy.
Treatment of periodontitis must be carried out urgently, because you risk not only losing a tooth, but also acquiring complications that are dangerous to the overall health of the body! How periodontitis occurs, what signs will help to identify the disease in a timely manner, how periodontitis is treated in dentistry, at what prices the service is offered in Moscow - we will talk about this in detail in this article.
Causes of dental periodontitis
Various reasons can lead to the appearance and development of dental periodontitis, but in the vast majority of cases the disease appears:
- Against the background of untreated dental caries and pulpitis;
- Due to poor quality treatment of tooth canals, or more precisely, mistakes made when filling the canals.
Less commonly, periodontitis occurs after injuries, incorrectly installed dental fillings, or violation of the dosage of dental medications.
Whatever the cause of periodontitis, its treatment cannot be delayed due to fear of dentists. It is important to understand that you will not stop the inflammation on your own, with pills or folk remedies, and the more it progresses, the less chance you have of saving the tooth. In addition, periodontitis can also affect neighboring healthy teeth.
How to identify periodontitis and not confuse it with caries or pulpitis? We already talked about the most striking symptom of the disease at the very beginning of the article, but the signs of periodontitis may vary depending on the form of the disease. Therefore, below we will consider the main types of dental periodontitis, as well as talk about their characteristic symptoms.
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Manukyan Artavazd Genrikovich
Chief physician of the clinic
Features of the treatment of periodontitis with fistula
Odontogenic fistula is one of the complications of periodontitis, mainly granulating. It consists of holes in the mucous membrane, which are formed due to the proliferation of granulations and destruction of the tissues surrounding the tooth. In severe cases, a fistula can appear not only in the gum, but also in the cheek, and even on the skin of the face. Purulent contents are released through the hole, which appears due to the inflammatory process in the periodontium.
On the one hand, the formation of a fistula facilitates the course of the disease, since inflammatory products are eliminated through it (which means that the patient most likely will not suffer from severe pain). On the other hand, non-intervention over time can lead to tooth loss.
You can get rid of a fistula only by eliminating its cause - damage to periodontal tissue. Treatment follows a standard scheme: mechanical treatment of the canals, disinfection and thorough filling. Due to the outflow of pus through the fistulous tract, treatment is most often successful and takes less time. After creating suitable conditions, the fistula goes away on its own, but in severe cases, surgical removal of overgrown granulations may be necessary.
Signs of acute periodontitis
Symptoms of acute periodontitis are always pronounced. Among them:
- Acute aching pain, the intensity of which is constantly increasing;
- Pain increases when trying to eat;
- If treatment for periodontitis was not started on time, attacks of pain will appear more and more often, and the intervals between them will become shorter and shorter;
Against the background of intense pain, a person cannot eat, speak, sleep, and may develop an elevated temperature. In the acute form of periodontitis, significant tumors and swelling often appear in the area of the diseased tooth. The cheek may also swell. This occurs due to the active accumulation of pus in the soft tissues of the oral cavity.
Features of the treatment of periodontitis in the acute stage
Exacerbation of periodontitis goes through two phases: intoxication and exudation (appearance of discharge). As the disease progresses, the patient first experiences aching and episodic pain, and then constant throbbing and tearing pain, so treatment cannot be delayed.
Acute periodontitis can be serous or purulent. In the second case, purulent exudate accumulates in the apical part of the tooth root, and the main task for the doctor is to remove it. Sometimes this is enough to clean the tooth cavity and treat the canals, but in severe cases it may be necessary to cut the periosteum for drainage.
Symptoms of chronic periodontitis
Chronic periodontitis is a very insidious form of the disease, since it can develop completely asymptomatically. It is extremely rare for a person to feel a slight pain when trying to bite something on a sore tooth; sometimes unpleasant sensations appear when consuming hot food and drinks.
Chronic periodontitis of the tooth is diagnosed with an x-ray, which clearly shows the process of bone destruction at the apex of the tooth root. This form of the disease has its own classification, according to which there are: fibrous, granulating and granulomatous periodontitis. With fibrous periodontitis, there is almost no pain, which is why it is most often recognized either in the acute phase or during an examination by a dentist and x-rays.
Treatment of this form of periodontitis is quite simple and is carried out in 1-2 visits to the doctor. Granulomatous chronic periodontitis most often develops asymptomatically, but under the influence of certain external factors it easily turns into an acute form. The disease has its own characteristic symptom, manifested in the formation of granulomas - capsules with pus, which separate tissues affected by inflammation from healthy ones. The treatment process for granulomatous periodontitis is long and complex, it can last for several months and even require surgical intervention!
Stages of periodontitis treatment
The number of visits to the clinic for the treatment of periodontitis depends on the stage of the disease (acute periodontitis, chronic, chronic in the acute stage) and the chosen technique. Often, therapy is carried out in several stages and requires at least 2 - 3 visits to the attending physician, since it is not recommended to install a permanent filling until the inflammation is completely removed.
- Preparation for treatment: diagnosis using an x-ray, anesthesia injection.
- Drilling a tooth to access canals, removing a nerve, or removing an old filling.
- If necessary, expand channels.
- Antiseptic treatment of canals, application of medications, physiotherapeutic procedures.
- Installation of a temporary filling.
- Removal of the temporary filling, antiseptic treatment of the canals (this stage is repeated until the source of inflammation is completely eliminated; sometimes this may take several months).
- Installation of a permanent filling, control x-ray.
In parallel, the patient is prescribed antibacterial and anti-inflammatory therapy, as well as home rinses with disinfectant solutions.
How does the acute phase of chronic periodontitis manifest?
When exacerbated, chronic periodontitis of the tooth expresses itself with the same symptoms as the acute form of the disease. That is, there is a strong, aching pain, swelling of the gums and swelling of the cheek. Typically, chronic periodontitis enters the acute phase when the immune system is weakened, the flu, ARVI, or simply severe hypothermia are present. If, during an exacerbation of the chronic form, a fistula appears in the gum area, pus will flow from the area of inflammation and the pain in the tooth will gradually subside.
But this does not mean that periodontitis has gone away on its own; the inflammatory process will continue to develop and will manifest itself again under favorable external factors, which we discussed just above. Based on the type of periodontitis, a treatment regimen is selected. The price of the service depends on the regimen chosen for treating the disease. We will tell you below about all the stages of treatment of dental periodontitis in different forms and prices for procedures. But no matter in what form periodontitis develops, its treatment always begins with diagnosis.
Diagnosis of periodontitis involves examination of the oral cavity, x-rays, and examination of patient complaints. All this together helps to accurately diagnose the form of periodontitis and prescribe adequate and effective treatment.
Stages and forms of the disease
Periodontitis is divided according to the general principle into chronic and acute. Chronic cannot be completely cured. It is only possible to eliminate local inflammation and stop further exacerbation of the disease. Chronic periodontitis is asymptomatic and does not bother the carrier, but in case of exacerbation of the disease, symptoms begin to appear. In a calm state, a small fistula may appear on the gum from time to time, and slight discomfort may occur when chewing food or mechanical impact on the area of inflammation. If left untreated for a long time, the risk of tooth loss is high.
Treatment of acute periodontitis has an end result. But even after complete recovery, control over the oral cavity is necessary to avoid re-inflammation. In acute periodontitis, all of the listed symptoms are characteristic, only 2-3 of them may appear, and this is already a signal to visit the dentist. Purulent periodontitis is especially pronounced. In this case, the pain is acute, body temperature rises, and gumboil formation is possible.
Forms of periodontitis:
- Fibrous. In this case, periodontal tissue is replaced by fibrous tissue. It is often asymptomatic and can be detected by external signs: changes in enamel color, bad breath, pulp death.
- Granulating. It leaks quickly and destroys bone tissue. It is characterized by painful sensations when pressing on the gums or chewing food. A pulling or bursting pain may be observed without mechanical impact on the tooth.
- Granulomatous. This is a dangerous type of disease because it is asymptomatic, while destructive processes take place inside the periodontium, which are accompanied by the appearance of cysts and granulomas. If left untreated, the tooth may simply fall out. An infection locked in a granuloma or cyst can “explode” under the influence of the slightest irritant: provoke inflammation (for example, sepsis).
- Apical. The simplest form, easy to treat. It occurs as a result of untreated pulpitis and is localized in one place near the root.
Anti-inflammatory drugs
In the treatment of periodontitis, drugs from the group of non-steroidal anti-inflammatory drugs are used, which quickly act on the site of the disease, eliminate pain, and relieve inflammation.
The most commonly used anti-inflammatory tablets for periodontitis are:
- Analgin
- Paracetamol
- Nimesulide
- Diclofenac
- Tempalgin
Nonsteroidal anti-inflammatory drugs often have a negative effect on the mucous membrane of the digestive system, so they should be used with caution by people with stomach diseases.
Treatment of periodontitis at home
Periodontitis cannot be cured at home, since the disease is caused by bacteria that colonize the dental canals. The only way to get rid of them is to carry out antiseptic treatment and sealing of the canals, and this can only be done by a doctor, but by waiting for a visit to the clinic, you can alleviate the symptoms and reduce pain.
Disinfectants that do not irritate the mucous membranes can be used for rinsing 4 - 5 times a day. Doctors also recommend rinsing with a solution of salt and soda, including after treatment, to relieve swelling and reduce inflammation. Non-steroidal anti-inflammatory drugs are suitable for pain relief. All this will help relieve symptoms, but is not a cure.
You may experience pain after periodontitis treatment. Normally, they last 3–5 days and gradually fade away. If the pain does not subside or returns with renewed vigor, re-therapy is necessary.
